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January 12, 2011

Survival From Out-of-Hospital Cardiac Arrest After Chest Compression–Only CPR—Reply

JAMA. 2011;305(2):147-148. doi:10.1001/jama.2010.1953

In Reply: In our study, we intentionally excluded the suspected noncardiac arrests because, a priori, we specifically focused our public health intervention of bystander COCPR on adults with sudden cardiac death, and we encouraged citizens to provide mouth-to-mouth rescue breaths for children and adults with respiratory causes for their arrests. We found (as have others1) that the vast majority of arrests were of presumed cardiac cause (79%). However, the question of whether some patients are potentially harmed by inadvertent COCPR is important. The proportion of patients with primary respiratory arrest or drowning (those expected to benefit from rescue breaths) was less than 5% of all arrests. Notably, among the entire adult group with a noncardiac cause, survival was very low and was not associated with the type of CPR (no CPR = 3.9%, conventional CPR = 3.8%, COCPR = 3.8%; P = .99).2

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